胺碘酮对心脏瓣膜术后华法林初始抗凝疗效的影响

目的：探讨胺碘酮对心脏瓣膜术后华法林初始抗凝疗效的影响。方法：选取2013年5月~2014年8月在我院接受心脏瓣膜术患者为研究对象，以术后口服胺碘酮为研究组，未服用者为对照组，分别记录患者基本信息、手术名称、术后肝肾功能、甲状腺功能及患者住院期间抗凝治疗情况。结果：研究组28例（24.35%），对照组87例（75.65%）。研究组INR首次达标时间（5.19±2.51）d，较对照组（6.49±2.52）d明显缩短（P=0.04），且INR达标维持时间（5.24±2.42）d，亦较对照组（6.90±5.37）d明显缩短（P=0.02）。两组患者华法林剂量、INR达标情况及不良事件发生率未见明显不同（P＞0.05）。结论：胺碘酮可缩短华法林初始抗凝达标时间，但未能提高抗凝总体达标率。

Effect of Amiodarone on Initial Anticoagulation of Warfarin in Patients after Heart Valve Surgery

Objective: To investigate the effect of amiodarone on the initial anticoagulant effects of warfarin after heart valve surgery. Methods: The patients who underwent heart valve surgery in our hospital in May 2013 to August 2014 were selected to record the basic information and the anticoagulant therapy during hospitalization. Results: There were 28 cases in the study group (24.35%) combining amiodarone treatment and 87 cases in the control group (75.65%). The INR target was reached the first time at (5.19±2.51) days in the study group, which was significantly shorter than that at (6.49±2.52) days (P=0.04) in the control group; and the INR target was maintained for (5.24±2.42) days in the study group, which was also significantly shorter than that for (6.90±5.37) days (P=0.02) in the control group. There was no significant difference on warfarin dosage, INR compliance or incidence of adverse events between the two groups (P>0.05). Conclusion: Amiodarone can shorten the initial anticoagulation time of warfarin but cannot improve the overall rate of anticoagulation.